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Block 2 Pharm > Diabetes Drugs > Flashcards

Diabetes Drugs Flashcards

1
Q

Insulin Preparations: Rapid Acting

A
  • Lispro
  • Aspart
  • Glulisine
    ONSET: 5-10mins
    PEAK: 1-2hrs
    DURATION: 3-4hrs
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2
Q

Insulin Preparation: Intermediate

A
  • NPH
  • Lente
    ONSET: 2hrs
    PEAK: 4hrs
    DURATION: 16hrs
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3
Q

Insulin Preparation: Long Acting

A
  • Glargine
  • Detemir
  • Ultralente
    ONSET: 60-90min
    PEAK: PEAKLESS
    Duration: >24hrs
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4
Q

Insulin Bolus Distribution

A
  1. 3-0.5 U/kg
    - 2/3 in AM (2/3 as NPH, 1/3 as Regular)
    - 1/3 in PM (1/2 as NPH, 1/2 as Regular)
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5
Q

Hypoglycemia S/S S/Sx [Autonomic]

A 
*BGL: 40-70*
Sympathetic
- Tremor
- Anxiety
- Paresthesia
- Palpitations
- Sweating
Parasympathetic
- Nausea
- Hunger

TX: Sugar

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6
Q

Factitious Hyperinsulinemia

A

Self ingested Insulin

  • Hypoglycemia
  • Antibodies
  • Suppressed plasma C Peptide
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7
Q

Glipizide

A

Helps your Pancreas make insulin

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8
Q

Hypoglycemia Tx

A

Glucagon
D50
Diazoxide

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9
Q

Diazoxide

A

MOA: INC K+ efflux, preventing Insulin secretion
TOXICITY: Hyperglycemia, Ketoacidosis

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10
Q

High Glucose Response

A

INC Insulin

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11
Q

Low Glucose Response

A

INC Glucagon, Cortisol, GH, Epi

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12
Q

Glucagon Clinical Uses

A

Severe Hypoglycemia
Endocrine Dx
Beta Blocker OD Antidote
Radiology of the Bowel (Relaxes intestines)

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13
Q

DKA Tx

A 
IV Insulin (Regular)
IV Fluids
D50
Correct Electrolytes
K+
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14
Q

Chronic Complications of DM

A

Retinopathy (leads to blindness)
Nephropathy
Neuropathy (Peripheral - Pain, Numbness and Tingling; Autonomic - Impotence and Gastropareisis)
Amputations

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15
Q

Peripheral Neuropathy Tx

A

GABA-Pentin

Pregabalon

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16
Q

Hypoglycemia S/S S/Sx [Neuroglycopenic]

A 
BGL Less than 40 mg/dL
- Dizziness
- Weakness
- Difficulty Concentrating
- Blurry Vision
- Feeling of warmth
- Drowsiness
- LOC
TX: D50 and Glucagon
17
Q

Insulin Preparation: Short Acting

A
  • SC/IV Regular Insulin
    ONSET: Less than 30min
    PEAK: 2-4hrs
    DURATION: 5-7hrs
18
Q

Goals for Therapy

A

FBS: 70-100
PPBS: Less than 140
HbA1C: Less than 7%

19
Q

Insulinoma

A
  • Benign Insulin Tumor
  • Serum Insulin 8 mg/dL w/ BGL less than 40 mg/dL
  • Inappropriate high insulin deposit w/ low BGL
  • 1mL Insulin = 1mL C Peptide
    RX: Surgery
20
Q

Difference b/w Hyperosmolar Coma and DKA

A

No Ketoacidosis

High BUN

21
Q

Tissues that Don’t Need Insulin

A 
Brain
RBCs
Intestines
Cornea
Kidney
Liver
22
Q

Insulin Secretagogues and Fxn

A

Sulfonylureas
Glitinides
- INC insulin production from Beta Cells
- SE - Hypoglycemia

23
Q

Insulin Sensitizers and Fxn

A

Biguanides - Weight Loss
Thiazolidinediones - Weight Gain
- Don’t Act on Beta Cells
- NO Hypoglycemia

24
Q

Alpha Glucosidase Inhibitors and Fxn

A

Acarbose
Miglitol
- Slow down digestion of starch so that glucose gets reabsorbed lower
- SE - GI Discomfort

25
Q

GLP1 Analoges and Fxn

A

Exenatide
Liraglutide
- Bind to Glucagon Receptors
- INC Insulin Production

26
Q

DDP4 Inhibitors and Fxn

A

Sitagliptin
Saxagliptin
- INC GLP1 - Reduces Glucagon - INC Insulin

27
Q

Amylin Analog and Fxn

A

Pramlintide

  • Slow gastric emptying
  • Suppress Glucagon
  • *Good for Type I AND II DM**
28
Q

SGLT Inhibitors and Fxn

A

Canagliflozin

  • Block reuptake of Glucose in Renal Tubules (Glucouria)
  • SE - Weight Loss and Hypoglycemia
29
Q

Sulfonylureas

A 
First Gen - Tolbutamide (Short Acting), Chlorpropramide (Long Acting - SIADH)
Second Gen (Lower dose, Less Side Effects) - Glipizide (Short), Glyburide (Long)

MOA: Block K+ Channels, INC Insulin
SE: Hypoglycemia, Weight Gain
CI: Renal & Hepatic Insufficiency
Drug Interations: INC effect in - Cimetidine, Insulin, Salicylates, Sulfonamides

30
Q

Biguanides

A

Metformin

MOA: DEC PP Glucose, INC Tissue Sensitivity to glucose
- NO HYPOGLYCEMIA OR WEIGHT GAIN
SE: GI Distress and Lactic Acidosis (w/ renal impairment and heart problems)
CI: Alcoholism, Renal hepatic Disease, Chronic cardiopulmonary dysfxn

31
Q

Thiazolidinediones

A

Pioglitazone
Rosiglitazone

MOA: Bind PPAR-y, INC Insulin Receptors, DEC Hepatogluconeogenesis
SE: Hypoglycemia (less than sulfonylureas), Weight Gain, Edema, Risk of Heart failure (Ros more than Pio)
CI: Heart Pts

32
Q

Acarbose

A

MOA: Delayed carb digestionAlpha-Glucosidase Inhibitor - Inhibits Glucose absorption, DEC PPBS
- NO HYPOGLYCEMIA OR WEIGHT GAIN
SE: GI Discomfort (Flatulence, Diarrhea, Hepatotoxicity

33
Q

Pramlintide

A

MOA: Delays gastric emptying (Acts on RANK), “fullness feeling”, Suppress glucagon release
SE: Hypoglycemia

34
Q

Exenatide and Liraglutide

A

MOA: Augments glucose dependent insulin secretion (Can be used in combo w/ Sulfonylureas or metformin)
SE: Nausea, Hypoglycemia, Necrotizing and Hemorrhagic Pancreatitis

35
Q

Sita/saxagliptin

A

MOA: Inhibit DDP4 to INC GLP1 - INC Glucose mediated insulin secretion and DEC glucagon levels
SE: Hypoglycemia, URTIs, Joint Pain, acute pancreatitis

36
Q

Canagliflozin

A

MOA: Block SGLT2 transporter - DEC Glucose Reabsorption
SE: Hypotension/Dehydration
CI: Severe Renal impairment

Block 2 Pharm (8 decks)

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